Micro - 4th Asessment - Viral Infections In Immunocompromized Host - 2007

Viral Infections in Immunocompromized Host 4th Year, February, 2007

Viral infections in IC Host, 1 

The case: A renal transplant patient presented with: fever leukopenia elevated liver enzymes

Viral infections in IC Host, 2 

Cytomegalovirus (CMV) Transmission by organs Reactivation – weeks after transplantation Clinical manifestations: Fever+leukopenia Retinitis Pneumonitis Intestinal bleeding

Viral infections in IC Host, 3 Diagnosis: - monitoring, early diagnosis antigen detection, PCR

Prevention: CMV Ab. neg. donors Treatment: Aciclovir, Valaciclovir

Viral infections in IC Host, 4 

Herpes simplex virus (HSV) Latency – reactivation Clinical manifestations: 1. Pneumonitis 2. Hepatitis 3. Encephalitis Diagnosis: antigen detection, virus isol. Prevention/treatment: Acyclovir, Foscarnet

Viral infections in IC Host, 5 

Varicella zoster virus (VZV) Latency-reactivation Clinical features: zoster (vesicular rash with dermatomal distribution) Diagnosis: Ag detection, virus isol. Prev: Vaccination Treatm: Acyclovir

Viral infections in IC host, 6 

Epstein-Barr Virus (EBV) Target cells – B lymphocytes B-cell lymphoma

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HHV-6 DNA in lung tissues of BMT patients Interstitial pneumonitis, encephalitis Pathology ???

Viral Infections IN IC Host, 7 HHV-7:

Infection could be detected earlier than CMV  Presence of HHV-7 DNA and CMV disease  Association with kidney rejection episodes HHV-8:  Kaposi sarcoma 

Viral Infections in IC Host, 8 Adenoviruses  BMT - disseminated disease, Type 32, 35  AHC - cyclophosphamide  Liver recip. - hepatitis  Kidney recip. – AHC, Type 11

Viral Infections in IC Host, 9 BK Polyomavirus (BKV)  Kidney recipients – BK virus nephropathy Interstitial nephritis

decoy cells 

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Diagnosis: decoy cells, histology, viral antigen, PCR Therapy: dosage of immunosppr. drugs Special attention: Mycophenolate mofetil

JC Polyomavirus (JCV)